Institut National des Études Démographiques, Paris, France.
Drug Alcohol Depend. 2011 Jan 15;113(2-3):229-35. doi: 10.1016/j.drugalcdep.2010.08.011.
Psychometric and screening properties of the Cannabis Abuse Screening Test (CAST) were investigated using DSM-IV diagnoses of cannabis dependence (CD) and cannabis use disorders (CUD) as external criteria. Performance of the binary and the full version of the CAST were compared.
The sample consisted of 2566 French adolescents aged 17 who reported cannabis use 12 months prior to the survey. The Munich Composite International Diagnostic Interview (M-CIDI) was used as a gold standard for DSM-IV diagnoses. Internal consistency (Cronbach's α), construct validity (exploratory and confirmatory factor analyses, correlation of CAST scores with related variables), and criterion validity (Receiver Operating Characteristic analyses) were assessed.
Both CAST versions were unidimensional and Cronbach's α was 0.748 for the binary and 0.775 for the full version. High and comparable AUC values indicate a good ability of both test versions to discriminate between individuals with and without a clinical diagnosis. Based on balanced sensitivity and specificity, the optimal cut-off scores for CD and CUD were 2 for the binary and 3 or 4 for the full version. While both versions largely overestimated CD prevalence, CUD prevalence was slightly underestimated.
The binary and the full version of the CAST are equally useful for screening for cannabis-related disorders. Both clinical and research applications of the scale are possible. The CAST may be used for estimating CUD prevalence rather than CD prevalence. The ultimate choice of the cut-off depends on the purpose of the specific study using the CAST.
本研究以 DSM-IV 对大麻依赖（CD）和大麻使用障碍（CUD）的诊断为外部标准，调查大麻滥用筛查测试（CAST）的心理测量学和筛查特性。比较了 CAST 的二分类版本和完整版本的性能。
该样本由 2566 名 17 岁的法国青少年组成，他们在调查前 12 个月报告了大麻使用情况。采用慕尼黑复合国际诊断访谈（M-CIDI）作为 DSM-IV 诊断的金标准。评估了内部一致性（Cronbach's α）、结构效度（探索性和验证性因素分析、与相关变量的 CAST 评分相关性）和标准效度（受试者工作特征分析）。
两个 CAST 版本均为单维结构，二分类版本的 Cronbach's α 为 0.748，完整版本的 Cronbach's α 为 0.775。高且相当的 AUC 值表明两个测试版本均具有良好的能力，能够区分有和无临床诊断的个体。基于平衡的灵敏度和特异性，CD 和 CUD 的最佳截断分数分别为二分类的 2 和完整版本的 3 或 4。虽然两个版本都大大高估了 CD 的流行率，但 CUD 的流行率则略有低估。
CAST 的二分类和完整版本都同样适用于筛查大麻相关障碍。该量表可用于临床和研究应用。CAST 可用于估计 CUD 的流行率，而不是 CD 的流行率。具体研究中使用 CAST 的最佳截断值的最终选择取决于该研究的目的。
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